Évaluation de la capacité de QFR® à prédire la perméabilité des pontages aorto-coronariens : une étude rétrospective au CHUV

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Accès restreint UNIL
Etat: Public
Version: Après imprimatur
Licence: Non spécifiée
ID Serval
serval:BIB_2D81985AEAD9
Type
Mémoire
Sous-type
(Mémoire de) maîtrise (master)
Collection
Publications
Institution
Titre
Évaluation de la capacité de QFR® à prédire la perméabilité des pontages aorto-coronariens : une étude rétrospective au CHUV
Auteur⸱e⸱s
KLOPFENSTEIN M.
Directeur⸱rice⸱s
FOURNIER S.
Détails de l'institution
Université de Lausanne, Faculté de biologie et médecine
Statut éditorial
Acceptée
Date de publication
2024
Langue
anglais
Nombre de pages
20
Résumé
Background
Coronary artery bypass graft (CABG) surgery is often the revascularization method of choice for patients with multi-vessel disease. Graft patency is influenced by patient factors and surgical technique. Among these different factors, competitive flow in the bypassed coronary arteries is a strong predictor of graft occlusion, impacting long-term outcomes. The more stenosed the native vessel, the less competitive flow there is, making it crucial to bypass only vessels with significant stenoses. Fractional flow reserve (FFR) is a widely used method for this purpose, and literature shows that lower FFR values in the native vessels correlate with higher grat patency rates. Non-invasive methods like three- dimensional coronary models and angiography-derived FFR software, such as Medis Quantitative Flow Ratio® (QFR®), offer cost-effective and accurate alternatives to invasive assessments. This study examines the ability of QFR® to predict long-term graft patency.
Method
Patients who underwent CABG preceded by coronary angiography at CHUV between January 2012 and December 2021 were enrolled if they had a subsequent coronary angiography after CABG. Patients data, including clinical and surgical details, were collected from medical records. Preoperative coronary angiographies were analyzed using Medis QFR® software to assess the severity of native vessel stenoses. Patency was then assessed based on follow-up angiography reports. In a sub-groupe analysis, patients were divided into two groups based on whether they only underwent a CABG surgery, or also a concomitant valve surgery.
Results
In total, 92 patients with 198 grafted vessels were included. Among these, 164 vessels were analyzable. QFR® was not a significant predictor of graft patency, with no statistical difference between occluded and patent vessels (0.70 vs 0.69, P = 0.5449). Similar results were observed for both isolated and combined surgery groups.
Conclusion
In this study, QFR® was not a significant predictor of graft patency, but several limitations are to consider such as the small sample size, affecting statistical power. Despite this, the study demonstrates the technical feasibility of QFR® in these vessels, a notable finding given the retrospective design. Future studies with larger cohorts and longer follow-up are needed to validate these findings and further explore QFR’s clinical utility.
Mots-clé
coronary artery bypass graft, coronary angiography, QFR® (Quantitative Flow Ratio), patency, post-operative follow-up
Création de la notice
30/08/2024 15:52
Dernière modification de la notice
18/10/2024 16:00
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